Several intracytoplasmic morphological changes in the plasma cells of multiple myeloma have been described previously. However, Auer rod-like inclusions are rarely found in these types of cells. Here, we report a case of multiple myeloma with Auer rod-like, needle-shaped intracytoplasmic inclusions in plasma cells. A review of all published cases revealed that this phenomenon is exclusively found in myeloma with kappa-type paraprotein. The nature of these intracellular inclusions and the relationship to prognostic implications and concomitant illnesses are discussed.